Medically Reviewed by Joshua A. Sibille, MD

When a person’s artery near the heart starts to expand like a balloon, the key for vascular specialists is to spot the problem and repair it before the “balloon” bursts, presenting a potentially fatal situation. McLeod Vascular Surgeon Joshua Sibille, MD, explains the problem and several approaches to mending the abdominal aortic aneurysm:

Here is a summary of Dr. Sibille’s explanation:

The abdominal aorta is the blood vessel that brings the blood from your heart down to your legs. It’s a specific area that — for whatever reason — tends to balloon out. It’s very common and the aneurysm has the risk of rupture. When that happens, the situations become potentially catastrophic.

It’s much more common in males than females. The highest prevalence is actually in white males. African-American and Asian males and females have a much lower risk. It tends to present in the ages of 65 to 75. There’s a very strong association with smoking. If you have a family history of someone who had or died from a ruptured aneurysm, then you have a much higher risk of having an aneurysm as well. It’s the 13th leading cause of death in the U.S., and overall, if you have a ruptured aneurysm, your mortality rate is about 75 percent.

There’s a lot that’s been done progressing the way we treat these. The initial way that we did this was open surgical repair. In the 1950s, Dr. Michael DeBakey in Texas used his wife’s sewing machine to create a Dacron graft, which he then implanted in a patient. This was how everything was done for decades and is still a standard. In younger patients, who are going to live 30-50 years and who present with a very early aneurysm, we’ll sometimes recommend this because it has proven data. The downside is that this is an open operation. You make a big incision in the abdomen. The patient is in the hospital for a week to 10 days.

One of the biggest advances we’ve made is the development of endovascular repair. This valve goes through the groins and the artery, the entire device can go through two small needle holes in the groin. It can seal up the expanded aorta and all of this area becomes depressurized. You significantly decrease the risk that this is going to rupture. This is a procedure most patients go home the next day, are back doing what they would do within a week.

Benefits include:

• Decreased pain. It’s 2 small needle holes versus an entire abdominal incision.
• Shorter time in the hospital — most patients with an open surgery are there for 7 to 10 days. Patients with what we call an EVAR are usually there for 1 to 2 days.
• Lower rates of pneumonia.
• Fewer blood clots.
• No risk of a hernia because they’re not making an incision in your abdomen.
• You tend to get back to your activity a lot faster, and
• Long-term outcomes have been shown to be, at least to eight years, as good as open repair, and may increase as newer devices and techniques are developments.

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